Objective To explore the clinical efficacy of neoadjuvant chemotherapy on advanced epithelial ovarian cancer.Methods From May 2006 to March 2010,60 patients with Ⅲ-Ⅳ stage advanced epithelial ovarian cancer were collected in Affiliated Cancer Hospital of Shanxi Medical University,which were divided into two groups based on different treatment methods.The observation group used the neoadjuvant chemotherapy,but the control group did not use it.The efficacy,operation time,blood loss,size of residual disease and the level of CA125 were observed to evaluate the safety and clinical efficacy of neoadjuvant chemotherapy.Results The total effective rate in the observation group was 60.0％.The satisfied cytoreductive rate was 70.0％,which was significantly higher than the control group (x2 =5.455,P ＜0.05).The mean operative time (127.21 ±27.62) min (t =10.113,P ＜ 0.05),intraoperative mean blood loss (408.5 ± 112.62) ml (t =5.047,P ＜ 0.05)and the level of CA125 (165.26 ±43.27) U/ml (t =14.100,P ＜ 0.05) in the observation group were significantly lower than the control group [189.33 ± 45.81) min,(590.6 ± 162.41) ml,(339.13 ± 51.86) U/ml].Five year survival rates of the observation group and control group were 36.7％ and 26.7％ respectively,with significant difference (x2 =8.492,P =0.036).Conclusion Neoadjuvant chemotherapy can play a positive role in the treatment of the patients with advanced epithelial ovarian cancer.

Early weaning from mechanical ventilation in children will lead to an extubation failure,however,prolonging mechanical ventilation will increase the risk of ventilator associated complication and the economical burden of disease.Nowadays there is no unified and objective ventilator weaning indexes in pediatrics,so it is significant to searching for appropriate and feasible ventilator weaning indexes.This article detailed the current progress on the condition and predictors of ventilator weaning in children,and comparing the predictability and accuracy of ventilator weaning indexes in children,also looking forward to the possibility of higher accuracy or scheme in ventilator weaning that used for clinical purposes.

The retinal vessel changes are the primary and major features of retinal vascular diseases.The retinal vessel is part of systemic vessels with its own characteristics to sustain normal retinal function.These basic characteristics are important to the correct understanding and proper treatment of retinal vascular diseases.Always keep in mind that the retinal vessels is one part of the systemic vascular system,thus retinal vascular diseases may have systemic etiology,and systemic drug administration may have a profound effects to the whole body.However retinal vascular system also has its own structural and functional characteristics,thus retinal vascular diseases are also different from the systemic diseases.Finally the main function of retinal vascular network is to maintain the neuro-retinal function,thus we should balance the vision protection and treatments against abnormal retinal blood vessels.Over-treatments may damage the retinal vision.

The paper gives a detailed description of the main features of American medical services,the characteristics of American hospitals,the responsibilities of hospital presidents and the problems faced by them.In addition,it introduces the macro-management of American hospitals and the existing problems.

Objective To evaluate the application value of ultrasound-guided minimally invasive stereotactic breast excision in the diagnosis and treatment of breast mass. Methods The minimally invasive operations for 218 patients were performed by ultrasound-guided Mammotome system, and the therapeutic efficacy of Mammotome system was evaluated. Results All the patients were completely excised by the Mammotome system. No failed procedure occurred,all the masses were pathologically confirmed as benign lesions in 214 patients and invasive ductal carcinomas in 4 patients. Postoperatively, the incision scar was barely visible and no complications happened except for mild subcutaneous hemorrhage in 9 patients,local hematoma in 3 patients and local deep pitting of the skin in 5 patients. Conclusion Mammotome system shows many benefits with less trauma, more rapid recovery and with less complications.

Objective To investigate the relationship between myeloid-derived suppressor cell ( MDSC) levels and immune function and hepatitis B virus DNA ( HBV-DNA) replication level in patients with hepatitis B. Methods 96 patients with hepatitis B were included in the study.40 normal persons who received physical examina-tion in the hospital during the same period were included as the control group.The content of MDSC was detected by flow cytometry and HBV-DNA level was detected by real-time fluorescence quantitative PCR technique.Statistical analysis was performed.Results The content of MDCS in hepatitis B group (8.77 ±3.69)%was significantly high-er than (1.64 ±1.26)%in the control group (t=16.80,P<0.05).The content of MDCS in HBsAg positive group (11.29 ±3.39)%was significantly higher than (4.71 ±2.88)%in HBsAg negative group (t=10.76,P<0.05). The proportions of HBA DNA<103 IU/mL,103 -104 IU/mL and 105 -106 IU/mL in HBsAg positive group(0.00%, 0.00%,9.09%) were significantly lower than those in HBsAg negative group (54.05%,22.97%,20.27%),while the proportion of HBA DNA>107 IU/mL ( 90.91%) was significantly higher than that in HBsAg negative group (2.70%)(P<0.05).The content of MDSC in HBV DNA positive group[(10.82 ±3.26)%] was significantly higher than that in HBV DNA negative group[(5.84 ±2.16)%](t=8.42,P<0.05).Spearman's correlation analy-sis showed that the level of MDCS expression was positively correlated with the level of DNA replication (r=0.769, P<0.05).Conclusion The increased level of MDSC content can cause the immune suppression and is positively correlated with the degree of HBV DNA replication.

Objective To study the clinical efficacy of low -calorie enteral nutrition support therapy for postoperative recovery in patients with primary hepatic carcinoma .Methods Retrospective analysis was performed in this study .120 patients, including partial liver or local liver resection , were divided into Hypocaloric parenteral nutrition group ( HPN) and Hypocaloric parenteral nutrition group ( HEN) by different nutritional treatment ways with each group of 60 case.Liver function ( TBIL, ALT, AST ) , nutrition indicators (ALB, PCHE, PA), immune function (CD4 +T cells, CD8 +T cells, CD4 +T cells/CD8 +T cell ratio), gastrointestinal tract function ( postoperative intestinal ventilation ) , the incidence of complications and nutritional support costs and hospitalization time difference were compared between two groups .Results Compared with the low -calorie parenteral nutrition group , TBIL, ALT, AST were significantly lower on low calorie enteral nutrition group (P<0.05); ALB, PCHE, PA, ALB, PCHE, PA, CD4 +T cells, CD8 +T cells, CD4 +T cells/CD8 +T cell ratio were significantly higher on low calorie enteral nutrition group ( P<0.05);low-calorie gastrointestinal function recovery, incidence of complications during hospitalization and nutritional support costs on enteral nutrition group were superior to low -calorie parenteral nutrition group .Moreover, the differences were statistical significance (P<0.05).Conclusion For postoperative pa-tients with primary hepatic carcinoma , both enteral and parenteral nutrition support therapies have significant effect , however ,enteral nu-trition therapy has more advantages , better clinical efficacy by comparing to parenteral nutrition therapy .Therefore, it is worthy of apply-ing in clinic .

Klotho gene is closely related to the aging,which plays an important role in modulation of mineral metabolism,anti-apoptosis,anti-oxidation and antisenescence,etc.Klotho deficiency leads to a syndrome resembling aging,such as shortened life span,atherosclerosis,skin atrophy,hyperphosphatemia,etc.This performance is similar to that of the patients with chronic kidney disease (CKD).The levels of klotho expression and transcription are down-regulated in CKD resulted from various causes.Thus,CKD may be viewed as a state of accelerated aging and/or an age-related disease associated with Klotho deficiency.This article reviewed the relationship between Klotho and CKD.

Objective To observe the therapeutic effect of compound glycyrrhizin on alcoholic hepatitis.Methods A total of 65 patients with alcoholic hepatitis were assigned to group A(30 cases) treated with abstinence of alcohol,physical exercise and adjusted diet, and group B(35 cases) treated with compound glycyrrhizin together with the treatment given to group A. Before and after receiving three 4-week treatment periods, all the patients had their liver function tested and received examination of ultrasonic weave type B. Results Group B had significantly alleviated clinical symptoms, and ACT,A ST, GGT in blood serum are significantly lower than group A(P＜0.05).Examination of ultrasonic wave type B on the liver shows significant amelioration and disappearance of symptoms of fatty liver. Conclusion Compound glycyrrhizin can significantly ameliorate the clinical symptoms and improve the liver function of the patients.

Hedgehog (Hh) pathway plays a critical role in embryonic development period,which regulates cell proliferation and differentiation,and coordinates the key step of organs' development process such as skin,brain,neural tube,bowels,appendage and lung.In the adult stage,Hh signaling regulates proliferation of stem cells.At this time,Hh signaling is strictly controlled by time and space.In recent years,studies have shown aberrant activation of the Hh pathway is closely related to various types of malignancies,and would be a new therapeutic target of tumor treatment.This paper will review the characteristic of Hh signaling pathway and its research status in lung cancer.